Abstract
The current concept and placement of treatment variety for esophageal and gastricvarices are described. There seems to be no objection against the management policy thatendoscopic therapy for acute variceal bleeding is the ffirst choice of treatment. Endoscopicinjection sclerotherapy(EIS)and endoscopic variceal ligation(EVL)have been establishedin the management of esophageal varices. However, EVL ensues higher incidence ofvariceal recurrence than that of EIS. Then, ccmbinatian therapy of EVL and EIS isdeveloped and considered to be safer procedure with less recurrence of varices. In the treatment of large sanitary gastric varices, endoscopic infection of tissueadhesive agent(histoacryl glue)is markedly effective, bud ligation therapy remains controversial despite utilizing endoscopic detachable snare ar improved large ligating device. The end-point of treatment for esophageal and gastric varices is complete eradicationby the procedure with less recurrence in Japan. For the elective and prophylactic purpose, the introduction of balloon-occluded retrograde transvenous obliteration(B-RTO)i. e. angiographic sclerotherapy is an epochmaking in the treatment modalities. This is highly effective for large solitary gastricvarices by a single session of treatment and can be employed even for cases of acutebleeding. When once successfully treated with B-RTO, variceal recurrence or rebleedingcan hardly be encountered. In the variety of treatment modalities for varices, one should select the procedureoption according to the patient's condition, not to doctor's condition.
